Association between angiotensin-converting enzyme (ACE) gene I/D polymorphism with the risk of knee OA: A systematic review, meta-analysis, and meta-regression.

Background: Previous studies have linked genetics to knee osteoarthritis. Angiotensin-converting enzyme (ACE) gene I/D polymorphism may cause OA. However, evidence remains inconsistent. This study examines knee OA risk and ACE gene I/D polymorphism. Methods: We explored Europe PMC, Medline, Scopus, and Cochrane Library using keywords. Three assessment bias factors were assessed using the Newcastle-Ottawa Scale (NOS). Criteria for inclusion: (1) Split the study population into knee OA patients and healthy controls; (2) Analysed the ACE gene I/D polymorphism; (3) Case-control or cross-sectional surveys. Studies with non-knee OA, incomplete data, and no full-text were excluded. The odds ratio (OR) and 95% confidence intervals (95% CI) were calculated using random-effect models. Results: A total of 6 case-control studies consist of 1,226 patients with knee OA and 1,145 healthy subjects as controls were included. Our pooled analysis revealed that a significant association between ACE gene I/D polymorphism and risk of knee OA was only seen in the dominant (DD + ID vs. II) [OR 1.69 (95% CI 1.14 - 2.50), p = 0.009, I2 = 72%], and ID vs. II [OR 1.37 (95% CI 1.01- 1.86), p = 0.04, I2 = 43%] genotype models. Other genotype models, including recessive (DD vs. ID + II), alleles (D vs. I), DD vs. ID, and DD vs. II models did not show a significant association with knee OA risk. Further regression analysis revealed that ethnicity and sex may influence those relationships in several genotype models. Conclusions: Dominant and ID vs. II ACE gene I/D polymorphism models increased knee OA risk significantly. More research with larger samples and different ethnic groups is needed to confirm our findings. After ethnicity subgroup analysis, some genetic models in our study showed significant heterogeneities, and most studies are from Asian countries with Asian populations, with little evidence on Arabs.

Praziquantel as the preferred treatment for schistosomiasis.

Schistosomiasis, caused by Schistosoma trematode worms, represents a significant global health challenge. This review offers a thorough examination of the disease's epidemiology, transmission dynamics, diagnostic modalities, and treatment options. Diagnostic techniques encompass direct parasitological methods, immunological assays, DNA/RNA detection, and biomarker utilization, each with distinct advantages and limitations. There is an urgent need for improved diagnostic tools with enhanced sensitivity and specificity. Praziquantel remains the cornerstone of treatment, exhibiting efficacy against all Schistosoma species, while the potential of artemisin derivatives in combination therapy is also explored. In this review, we focus on the importance of praziquantel administration as the central aspect of schistosomiasis treatment, highlighting ongoing efforts to optimize its utilization for improved patient outcomes.

Association between severity of sepsis and thyroid function profile.

BACKGROUND AND AIM: Critical illness conditions such as sepsis are often accompanied by altered hormone levels, which may result in decreased thyroid axis activity. This condition aims to provide metabolic substrates for vital organs such as the brain and immune system. Significant alteration of the thyroid axis in critical illnesses such as sepsis known as Low-T3 Syndrome which is associated with increased mortality. This study aims to determine the association between severity of sepsis and thyroid function profile as a predictor of mortality in sepsis patients. METHODS: An observational study involving 62 subjects with sepsis and septic shock. Serum was measured using Enzyme-linked Immunosorbent Assay (ELISA) method. Statistical analysis used Mann-Whitney, Kruskal-Wallis, and Spearman's correlation tests. Statistical test results are significant if the p-value <0.05. RESULTS: The median fT3 level was lower in the septic shock group 13.94 pg/ml (7.71-19.93) compared to the sepsis group 20.15 pg/ml (11.08-37.15) where there was a significant difference (p<0.001). There was a significant correlation between The Sequential Organ Failure Assessment (SOFA) score and fT3 levels (R: -0.270, p=0.032). The non-survivor group had a lower median fT3 level 16.56 pg/ml (7.71-30.03) compared to the survivor group 17.50 pg/ml (10.32-37.15) where there was a significant difference (p<0.036). CONCLUSION: Based on the severity of sepsis, the more severe the sepsis condition, the lower thyroid function levels are obtained where decreased thyroid function levels can be a prognosis indicator to predict mortality in sepsis patients.

Effect of age and gender on high - Sensitivity C - Reactive protein levels serum on health worker with latent tuberculosis and healthy control.

BACKGROUND: Latent tuberculosis is defined as a state of persistent immune response stimulated by Mycobacterium tuberculosis antigens with no evidence and signs of active TB . Health workers have a high risk of developing latent TB disease due to occupational exposure from patients. High sensitivity CRP (hs-CRP) assays have been developed for special values that may indicate low-grade inflammatory lesions as is true in measurement of latent tuberculosis infection. Factors that affect CRP levels are gender and age. Our study is conducted to asses effect of age and gender on Hs- CReactive protein leves serum on health worker with latent tuberculosis and healthy control. METHOD: This research is a cross sectional study using primary data. The research was conducted at Wahidin Sudirohusodo Makassa Hospital and Community Center For Lung Health In South Sulawesi. Studied subject were recruited by consecutivesampling, in which the patient who met the inclusion criteria and then the serum HsCRP test was measured. Data analysis was performed using SPSS version 25. RESULT: During the study period , 80 subjects met the inclusion criteria. At age ≤ 32 years, the mean HsCRP was found to be lower in latent TB than in healthy controls, but not statistically significant (p>0.370). At age >32 years, the mean HsCRP was found to be higher in latent TB than in healthy controls, but not statistically significant (p>2.49). In males, the mean HsCRP was found to be higher in latent TB than in healthy controls, but not statistically significant (P =0.584). In women, the mean HsCRP was found to be lower in latent TB than in healthy controls, but not statistically significant (P =0.712). CONCLUSION: Serum HsCRP levels were found to be higher in latent TB subjects with increasing age and male gender but not statistically significant.

Dynamic interaction of obesity, age, MCP-1 Level, and ACE-1 gene with the severity of knee osteoarthritis: a cross-sectional study.

The risk factors most strongly associated with knee osteoarthritis (OA) are old age and obesity. However, few studies have evaluated the interaction between aging and obesity in conjunction with inflammatory markers and knee OA severity as part of a complete assessment of knee OA management. Therefore, this study aims to evaluate the interaction between obesity, age, inflammation [including the I/D polymorphism of angiotensin converting enzyme-1 (ACE-1)], and the severity of knee OA. Methods: A total of 80 knee OA patients were included in this cross-sectional study. The severity of knee OA was determined based on the Kellgren-Lawrence system. All patients underwent physical and radiological examination; monocyte chemoattractant protein 1 (MCP-1) markers were measured. The parameters of the ACE-1 gene were examined with sequencing DNA. Results: There was a significant relationship between age and severity of knee OA (P=0.007), with subjects aged greater than or equal to 65 having a 3.56-fold higher risk of developing moderate to severe OA than subjects aged less than 65. There was a significant difference between body weight and knee OA severity (P=0.026), in which subjects weighing greater than or equal to 60 kg had 3.14 times the risk of experiencing severe knee OA. Multivariate regression analysis indicated that age was the strongest independent variable for knee OA severity compared with body weight. MCP-1 levels were significantly higher in mild knee OA than in moderate to severe knee OA. The DD genotype of the ACE-1 gene increases the risk of severe knee OA by four times in subjects aged greater than or equal to 65 compared to subjects aged less than 65. However, the DD genotype of the ACE-1 gene does not increase the risk of severe knee OA in subjects weighing greater than or equal to 60 kg. Conclusion: While obesity and age were found to be associated with the severity of knee OA, age emerged as the independent risk factor for knee OA severity. Furthermore, MCP-1 levels were significantly higher in cases of mild knee OA compared to severe knee OA. It was observed that the DD genotype of the ACE-1 gene increases the risk of severe knee OA in individuals aged 65 years or older.

The Relationship Between Admission Insulin Resistance Index (AIRI) and In-Hospital Outcome in Non-Diabetic Acute Coronary Syndrome.

Background: Acute coronary syndrome (ACS) is a major cardiovascular problem due to its high hospitalization and mortality rates. One of the risk factors for atherosclerosis that leads to ACS is insulin resistance (IR) which plays a role in the pathogenesis and development of cardiovascular events. This study aims to determine the relationship between IR and in-hospital outcomes in non-diabetic patients with ACS. Methodology: This was a cohort study conducted from January-June 2021. Insulin resistance was assessed using the Admission insulin resistance index (AIRI). This measurement was performed once during the patient's admission, and then the outcome was observed during hospitalization. The observed in-hospital outcomes were composite outcomes; namely, heart failure, arrhythmia, cardiogenic shock, and death. The statistical tests used were ANOVA, independent T and Chi-Square tests. Statistical test results were considered significant if p<0.05. Results: This study included 60 subjects (51 males and 9 females). Analysis revealed that AIRI was higher in patients with composite outcomes (mean 9.97 ± 4.08) than in patients without composite outcomes (mean 7.71 ± 4.06) (p<0.05); AIRI was higher in patients with heart failure (mean 10.72 ± 3.83) than in patients without heart failure (mean 7.25 ± 3.84) (p<0.001). Patients with IR had a higher rate of heart failure complications [OR 5.5 95% CI (1.56-19.38) (p=0.005)]. Conclusion: There is an association between AIRI and composite outcomes. Patients with IR have 5.5 times the risk of developing heart failure.

Hemostatic parameters in pulmonary tuberculosis patients after intensive phase treatment.

BACKGROUND: Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis (Mtb). This infection causes the release of proinflammatory cytokines that affect hemostasis. Pulmonary TB infection causes an increased activation of procoagulant factors, decreased anticoagulant factors and suppresses fibrinolysis which causes hypercoagulable. Our study is conducted to assess the association between pulmonary TB infection (PTB) with hemostatic parameters before and after intensive phase treatment. METHODS: This was an analytic observational prospective cohort design. The study was conducted at the Community Center for Lung Health in South Sulawesi. Studied subjects were recruited by consecutive sampling, in which the patients who met the inclusion criteria received intensive phase of ATD treatment. PT, aPTT, fibrinogen, and D-dimer were measured before treatment and after the intensive phase of ATD. These data were analyzed using the SPSS Version 22. RESULTS: In this study, 30 subjects are new cases of PTB. Prothrombin time, aPTT and D-dimer levels were higher in far advanced lesions and smear-positive sputum group (p<0.001). There was a significant level decrease in PT, aPTT, fibrinogen, D-dimer after intensive phase treatment (p<0.001). CONCLUSION: Pulmonary tuberculosis infection is associated with hypercoagulability which is characterized by an increase in hemostatic parameters and has significant improvement after intensive phase of ATD treatment.

High uric acid level increases the risk of acute kidney injury in acute coronary syndrome patients.

BACKGROUND: Both clinical and experimental evidence have been published over the past few decades supporting the existence of a close relationship between the elevated levels of serum uric acid with cardiovascular events and acute kidney injury (AKI). This study aimed to determine the effect of serum uric acid levels on the incidence of AKI in acute coronary syndrome (ACS) patients. METHODS: A retrospective cohort study with a cross sectional design was performed. The research was conducted at Dr. Wahidin Sudirohusodo Hospital from October 2019 to December 2019. Nonrandom sampling was employed in the medical records. All patients who met the inclusion criteria were at > 18 years old and diagnosed with ACS with AKI. The demographic data of age, sex and serum uric acid levels were recorded. The data obtained were analyzed using the SPSS (Statistical Package for Social Sciences). RESULTS: There were 158 subjects of ACS patients with AKI and 135 without AKI. There was a significant correlation between high uric acid levels with the incidence of AKI in ACS (p<0.001). Patients with high serum uric acid levels were 9.5 times at risk of developing AKI compared to those with normal serum uric acid levels. CONCLUSION: High uric acid level is one of the risk factors for AKI in ACS and indicates 9.5 times at risk of developing AKI compared to normal serum uric acid level. Therefore, it is necessary to monitor serum uric acid level and kidney function in ACS patients.

Profiles of endoglin and vascular endothelial growth factor based on staging and histological grading of colorectal cancer and their relationship with bevacizumab therapy / Perfis da endoglina e do fator de crescimento endotelial vascular com base no estadiamento e na graduação histológica do câncer colorretal e sua relação coma terapia com bevacizumabe

Objective: The present study evaluated the profile of endoglin (CD105) and vascular endothelial growth factor (VEGF) based on staging and histopathological grading of colorectal cancer as well as their relationship with bevacizumab therapy. Methods: A total of 88 cases of colorectal adenocarcinoma were included in the present study. The levels of VEGF and CD105 protein were evaluated with enzymelinked immunosorbent assay (ELISA). Results: There was a significant difference in the level of CD105 (p=0.002) between metastases and non-metastases subjects, showing that CD105 was higher in metastases subjects (4.59 ng/ml). Therewas no significant difference in the level of VEGF based on the presence of metastasis (p=0.625). There was a significant difference in the levels of CD105 (p=0.038) and VEGF (p=0.010) between the subjects who received chemotherapy and those who did not. The CD105 level was higher in the subjects who received chemotherapy (4.43 ng/ml); conversely, the level of VEGF was lower in subjects who received chemotherapy (543.65 pg/ml). There was a statistically significant difference in the levels of CD105 (p=0.003) and VEGF (p=0.002) between subjects who received bevacizumab therapy and subjects who did not. The levels of CD105 were higher in subjects who received bevacizumab therapy (5.11 ng/ml); in contrast, the level of VEGF was higher in subjects who did not receive bevacizumab therapy (645.92 pg/ml). There was a significant positive correlation between CD105 and VEGF in subjects who did not receive bevacizumab (p<0.01). Conclusion: The results of this study support a hypothesis of "escape mechanism" in the failure of anti-angiogenesis therapy (anti-VEGF). (AU)

Objetivo: Este estudo avaliou o perfil da endoglina (CD105) e do fator de crescimento endotelial vascular (FCEV) com base no estadiamento e graduação histopatológica do câncer colorretal, assim como sua relação com a terapia com bevacizumabe. Métodos: No total, 88 casos de adenocarcinoma colorretal foram incluídos no presente estudo. Os níveis das proteínas FCEV e CD105 foram avaliados com ensaio imunoenzimático (ELISA, na sigla em inglês). Resultados Houve uma diferença significativa no nível de CD105 (p=0,002) entre indivíduos commetástases e semmetástases, que indicou que o nível de CD105 émais alto em indivíduos com metástases (4,59 ng/ml). Não houve diferença significativa no nível de FCEV com base na presença de metástases (p=0,625). Houve diferença significativa nos níveis de CD105 (p=0,038) e de FCEV (p=0,010) entre os indivíduos que receberam quimioterapia e os que não receberam. Encontrou-se um nível de CD105 mais alto nos indivíduos que submetidos a quimioterapia (4,43 ng/ml); Em contrapartida, encontrou-se um nível de FCEV mais baixo em indivíduos que submetidos a quimioterapia (543,65 pg/ml). Houve uma diferença estatisticamente significativa nos níveis de CD105 (p=0,003) e de FCEV (p=0,002) entre os indivíduos submetidos e não submetidos à terapia com bevacizumabe. Os níveis de CD105 foram mais elevados em indivíduos submetidos à terapia combevacizumab (5,11 ng/ml); em contraste, observou-se um nível de FCEV mais alto em indivíduos que não foram submetidos à terapia com bevacizumabe (645,92 pg/ml). Houve uma correlação positiva significativa entre CD105 e FCEV em indivíduos que não receberam bevacizumabe (p<0.01). Conclusão: Os resultados deste estudo corroboram a hipótese de "mecanismo de escape" na falha da terapia anti-angiogênica (anti-FCEV). (AU)

Syndrome of Inappropriate Antidiuretic Hormone in Esophageal Cancer Patient.

Syndrome of inappropriate antidiuretic hormone (SIADH) is a disorder of fluid and sodium balance characterized by hypotonic hyponatremia, low plasma osmolality, and increased urine osmolality caused by excessive release of antidiuretic hormone (ADH). Malignancy is one of the most common causes of SIADH, but SIADH in esophageal carcinoma is very rarely reported. In this case report, a 74-year-old male patient of moderate differentiation of squamous cell esophageal carcinoma had a recurrent electrolyte balance disorder despite repeated corrections. The patient experienced improvement after fluid restriction and drug administration.

Albumin excretion rate among patients with diabetic retinopathy.

BACKGROUND: Chronic microvascular complications consist of diabetic nephropathy (DN), diabetic retinopathy (DR), and diabetic neuropathy. Diabetic nephropathy is assessed through albuminuria, and diabetic retinopathy is assessed through fundoscopy. Several studies have assessed the albuminuria in diabetic retinopathy but have found inconclusive results. This study aims to investigate the albumin excretion rate in patients with diabetic retinopathy. METHODS: A cross sectional design was applied in this study. The diagnosis of type 2 diabetes mellitus was determined based on the anamnesis and laboratory examinations. The study was conducted at Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital in Makassar during November 2018 until April 2019. The stages of diabetic retinopathy were based on funduscopic examinations. In addition, the blood pressure, BMI, albumin excretion rate, lipid profile, and HbA1C were also examined. Chi Square and Kappa tests were performed in the statistical analysis. RESULTS: 120 subjects with type 2 diabetes mellitus were observed. Of the total subjects, the number of females within the age of 36-79 years made up the biggest fraction. There was a significant relation between hypertension comorbidity with the albumin excretion rate and grading diabetic retinopathy where the A3 and proliferative diabetic retinopathy (PDR) percentages were higher in the hypertension group at 68.8% and 54.5%. There was also a significant correlation between incidence of albuminuria with diabetic retinopathy. Particularly, proliferative diabetic retinopathy (PDR) remained associated with albuminuria, while non-proliferative diabetic retinopathy (NPDR) was related to non-albuminuria. CONCLUSION: Albuminuria incidence confirms association with diabetic retinopathy grading.

The association between metabolic syndrome components, low-grade systemic inflammation and insulin resistance in non-diabetic Indonesian adolescent male.

BACKGROUND AND AIMS: Millions of people in Indonesia have diabetes. The cluster of metabolic abnormalities has long been identified as the risk factors for type 2 diabetes and is now commonly described as metabolic syndrome/MetS. Insulin resistance takes a key role in the process of the MetS and has even been hypothesized as its underlying cause. Clinical and epidemiologic studies also indicate that inflammatory factors might be correlated with IR. Prospective studies have proved that metabolic syndrome grows during childhood/adolescence and progresses to adulthood T2DM. The purpose of this study was to investigate relationships between metabolic syndrome components and low-grade systemic inflammation with insulin resistance in non-diabetic Indonesian adolescent male. METHODS: This was a cross-sectional analysis of non-diabetic adolescent male in Indonesian population (n = 128) aged between 18 and 22 years old. MetS components are based on NCEP ATP III (2004) modification for Asia Pacific population. Marker for low-grade systemic inflammation is hsCRP and insulin resistance was determined by HOMA-IR formula. Relevant measures were anthropometry, blood pressure, fasting insulin, serum glucose, lipid profiles and hsCRP. RESULTS: Of the 128 adolescent male, we found that 16 subjects (12.5%) have central obesity; 3 subjects (2.3%) have hyperglycemia; 26 subjects (20.3%) have low HDL-c; 19 subjects (14.8%) have high triacylglycerol; 45 subjects (35.2%) have hsCRP ≥1.0 mg/dL; 4 subjects (3.1%) have high blood pressure and 39 subjects (30.5%) have insulin resistance. The association of MetS components with the risk of insulin resistance is central obesity and high triacylglycerol with OR of 24.4 (95%CI: 5.19-114.42) and 9.4 (95%CI: 3.09-28.68) consecutively. We also found that low-grade systemic inflammation (hsCRP ≥1.0 mg/dL) was strongly associated with incident of insulin resistance with OR 5.2 (95%CI: 2.31-11.64). Meanwhile, we found that high triacylglycerol level is the solely one of five MetS components which has contribution to the incident of systemic low-grade inflammation with OR 3.9 (95%CI: 1.43-10.92). CONCLUSION: Central obesity and high triacylglycerol level are the important MetS components associated with IR. Systemic low-grade inflammation has been associated with insulin resistance. Identification of obesity, high triacylglycerol and high hsCRP should be focused for prevention of type 2 diabetes in non-diabetic Indonesian adolescent male.

Relationship between Vitamin D Level and Serum TNF-α Concentration on the Severity of Chronic Obstructive Pulmonary Disease.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease and disturbed bacterial clearance. Vitamin D deficiency is sometimes observed in COPD patients and as significant roles in increasing inflammation of airway obstruction and systemic obstruction, increasing pro-inflammatory cytokine including TNF-α, reduction of bacterial clearance and increase exacerbation risk due to infection. Also, vitamin D plays significant roles in the metabolism of calcium and mineralisation of bones and regulation system of immune. TNF-α also has essential roles in pathogenesis and inflammation of COPD. Several studies that investigate the relationship between vitamin D level and serum TNF-α concentration in COPD patients are relatively uncommon, including in Indonesia. AIM: This study aimed to assess the relationship between vitamin D level and TNF-α concentration in patients on the severity of the chronic obstructive pulmonary disease. METHODS: This study was a hospital-based descriptive cross-sectional study. Total samples were 50 COPD patients with the average age of older than 60 years during their enrollments at the Department of Pulmonology and Respiratory Medicine of the Dr Wahidin Sudirohusodo General Hospital Makassar in September 2018-January 2019. All procedures of the present study were reviewed and approved by the Research Ethics Committee of Medicine Faculty of Hasanuddin University. The severity of COPD was assessed according to the combination of COPD assessment stages that referred to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guideline 2015 that consisted of the combination of scoring COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) questionnaire and results of the spirometry measurement. Assessment of airway obstruction levels referred to the GOLD spirometry criteria. Determination of thoracic photographs was conducted to verify the COPD diagnosis of the severity of COPD. Determination of serum TNF-α concentration and vitamin D3 [1,25(OH)2D3] level used the ELISA method. RESULTS: The majority of COPD patients were observed in the category of older than 60 years old accounted for 34 COPD patients (68%), and the majority of COPD patients were males accounted for 47 males with COPD (94%). The majority of COPD patients were observed in the group of D (38%). All the study subjects observed in this study were smokers, and 82% of them were in the category of heavy smokers. 21 study subjects had higher concentration of serum TNF-α (tertile 3 = 0.21-1.83 pg/dl), 20 study subjects and lower level of vitamin D (tertile 1 = 182.1-364.5 pg/dl). The majority of the study subjects (38%) were in the category of severe COPD (category D of the severity of COPD at the tertile 3) according to the GOLD Combine Assessment. Given the relationship between vitamin D level and serum TNF-α concentration on the airway obstruction, there were significant positive correlations between the increase of vitamin D levels and the increase of serum TNF-α concentrations on airway obstruction. Given the relationship between vitamin D level and serum TNF-α concentration on the severity of COPD, there were significant positive correlations between the increase of vitamin D levels (tertiles 1, 2 and 3) and the increase of serum TNF-α concentrations on the severity of COPD at p-value < 0.05. Overall, there were non-linear relationships between vitamin D level and serum TNF-α concentration on the severity of COPD. CONCLUSIONS: Serum TNF-α concentration was positively associated with airway obstruction level and severity of COPD. Low level of vitamin D was negatively associated with airway obstruction level and severity of COPD. Vitamin D3 level (1,25(OH)2D) was negatively associated with serum TNF-α concentration and airway obstruction level and severity of COPD.

The Association Between Parents History of Type 2 Diabetes with Metabolic Syndrome Component and Insulin Resistance in Non-Diabetic Young Adult Male.

BACKGROUND: the familial nature of type 2 diabetes is manifested by the presence of insulin resistance in non-diabetic first degree relatives. Most of these studies have been performed in middle-aged and there is only few published studies in young age individuals and adolescents. This study aimed to determine the relationship between parents history of type-2 diabetes with metabolic syndrome component and insulin resistance in adolescent non-diabetic subjects. METHODS: this was a cross sectional study comparing the metabolic profile, risk of metabolic syndrome and insulin resistance in non-diabetic male adolescents (17-24 years old) whose one or both parents were with type-2 diabetes. We performed anamnesis, physical examination, fasting plasma glucose, lipid profile, fasting insulin level and insulin resistance based on HOMA-IR. RESULTS: metabolic abnormalities were more prevalent in subjects whose parents were with history of type-2 diabetes, especially their waist circumference, fasting plasma glucose, triglyceride, fasting insulin and HOMA-IR (p=0.000). There was increased risk of developing central obesity in adolescents with parental history of 19.3 fold (95%CI 2.46-151.07) and insulin resistance of 10.3 fold (95%CI 3.89-27.23). Parental history of type-2 diabetes together with metabolic syndrome component ie. waist circumference >90 cm and triglyceride ≥150 mg/dl were strong determinat factors for insulin resistance (R2=50.7%). CONCLUSION: the early multiple metabolic defect can be detected in non-diabetes adolescents with parental history of type-2 diabetes. Cluster of metabolic syndrome component in these subject become  a powerful determinat factor for insulin resistance.

Intra-uterine Growth Retardation and Development of Hypertension.

Low birth weight (LBW) is defined as a birth weight of a liveborn infant of <2,500 gram. In developed countries, LBW is commonly caused by preterm birth; while in developing countries, it is mostly due to intrauterine growth retardation. The concept of developmental origins of adult diseases, particularly on late-onset diseases such as hypertension and kidney disease, implies that there is a correlation between intrauterine milieu, intrauterine growth retardation, premature birth and infant feeding. The 'fetal origin hypothesis' suggests that metabolic diseases are directly related to poor nutritional status in early life.There is an inverse association between LBW and later risk of hypertension. The pathomechanism that links LBW and hypertension is multifactorial including delayed nephrogenesis, genetic factors, sympathetic hyperactivity, endothel dysfunction, elastin deficiencies, insulin resistance and activation of renin-angiotension system.

The Role of Endothelial Progenitor Cell in Cardiovascular Disease Risk Factors.

Endothelial progenitor cells (EPCs) are cell derived from bone marrow and the cells circulate in peripheral blood. These cells have characteristics similar to stem cells, but their ability to proliferate and differentiate is more limited. EPC discovery has changed the old paradigm in the field of vascular biology and it brings huge implications in medicine as EPCs can mediate the processes of vasculogenesis and maintain the vascular integrity. Increasing amount of EPC in the circulation is important since it has positive correlation with reendothelialization and neovascularization and they are closely linked to cardiovascular health. Thus, EPC could potentially be used for treatment of disease caused by endothelial dysfunction.

Secretory Phospholipase A2 Is Associated with the Odds of Acute Coronary Syndromes through Elevation of Serum Amyloid-A Protein.

In coronary heart disease (CHD), levels of secretory phospholipase A2 (sPLA2) are commonly increased. Serum amyloid-A (SAA) is increased in acute coronary syndromes (ACS) as well. It is needed to verify the hypotheses that sPLA2 is associated with the odds of ACS through elevation of SAA. We conducted a case-control study with 57 male patients with ACS and 30 controls matched by gender category. Levels of sPLA2, SAA, and myeloperoxidase (MPO) were measured by immunoreactive assay on the basis of a double-antibody sandwich technique. Levels of sPLA2, MPO, and SAA were significantly higher in patients than those in controls (11,359.0 ± 10,372.4 pg/mL vs. 1,320.5 ± 654.5 pg/mL, p = 0.00; 438.6 ± 310.7 ng/mL vs. 271.1 ± 176.8 ng/mL, p = 0.01; 10,995.2 ± 2,842.6 ng/mL vs. 3,861.7 ± 3,173.5 ng/mL, p = 0.00). There were significant correlations between age, visceral obesity, MPO, sPLA2, and SAA (r = 0.43; p = 0.00; r = 0.30; p = 0.00; r = 0.28; p = 0.00 and r = 0.53; p = 0.00). On multivariate logistic regression analyses, there were significant and independent associations between sPLA2 and SAA with odds of ACS [OR (95% CI) = 14.2 (2.1 to 98.6), p = 0.00; OR (95% CI) = 44.9 (6.9 to 328.4), p = 0.00]. Our findings suggest that sPLA2 may be associated with the odds of ACS compared with controls through increased inflammation, represented by elevated SAA.

Angiotensin-converting enzyme gene polymorphisms, blood pressure and pulse pressure in subjects with essential hypertension in a South Sulawesi Indonesian population.

AIM: to investigate the potential association between the ACE gene polymorphism, essential hypertension and pulse pressure. METHODS: the study included 99 non-hypertensive and 104 hypertensive subjects. Hypertension is defined as systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg. Pulse pressure refers to the differences between the systolic blood pressure and diastolic blood pressure. DNA amplication to examine ACE I/D polymorphism was conducted by Rigat-modification PCR method. RESULTS: this study showed no significant difference in genotype distribution and allele frequency between two groups. We found PP >60 mmHg is different between ACE gene genotype. Genotype DD has a risk of 1.8 times of having PP >60 mmHg than ID genotype while DD genotype has a risk of 4.4 times of having PP >60mg than II genotype. CONCLUSION: this study does not support that the I/D polymorphism at ACE gene locus associated with hypertension in Makassar, South-Sulawesi, Indonesia. However, there were a significant correlation with pulse pressure independent from blood pressure.